sinemet dosing ...

Hi, I currently take sinemet 25/100 4x daily and myripex 3x daily. I have noticed that after taking my first dose of sinemet in the morning, I often can't make it the whole 4 hours until the next dosage. I have begun taking the second sinemet after 3 hours, but have begun to feel quite nauseous and "not quite right". Has anyone else experimented with their dosages? I am thinking of maybe taking 1 and 1/2 sinemet as my first dose. Any thoughts from anyone?? Thanks so much.

[parkie-Al]

Hi

I am also on sinimet , i have messed about with it in the past but it just make you worse off

as far as the nauseousness is concernd i take domperidone tabs 20 mins befor the sinimet to help,

i have been taking them of over a year now and it workes most of the time , i was on Stalevo for a few months but that done ma nut in.

hope this helps

if you have a PD nurse tell her to sort it out for you

al

[Hidden in reply to parkie-Al]

thanks!

[Hikoi]

Hi

Yes i am a very similar regime (requip instead of Mirapex) and have exactly that problem. I am one to play around with timings until i find what suits. It was helpful to hear a person on another forum say he took 2nd dose 3 hours after first then 4 hourly after that. As l dopa has a life of about 3 hours this made sense.

Re nausea, i'm not sure that domperidone is available in the states unfortunately but have you tried taking your med with a non protein snack, biscuit.

Some pople have an extra dose of sinimet in the morning to get them going as you suggest, depending on symptoms it can be the disolvable quick acting med along with a regular sinemet. Personally id try what you think is the best regime and give it a couple of weeks to settle.

I agree with Al about a routine, i try to stick to one once i have found what works best for me.

[Hidden in reply to Hikoi]

Thanks so much; I am trying 1 and 1/2 sinemet (25/100) first thing in the morning along with some bread. Next dose will be at noon. will see how that works out!

[wordworks2001]

Everyone is different. Everyone I know, including myself, who has been on l-dopa/c-dopa for any length of time will develop "wear off" periods where the drug doesn't last as long as it did when we first started taking it. With some of us, the medication stops working altogether in 15 years or less. Sometimes dopamine agonists and other medications can make the l-dopa/c-dopa last longer. I am lucky. I started taking l-dopa/c-dopa in 1998 and am on the same dose today as I was when I started. My neurologist has always augmented my regimen with other meds to enhance the effect of the l-dopa/c--dopa. Right now I am on Azilect 1mg in the morning and Comtan 200 mg morning and evening.

[rch21]

as someone else already said, we each react uniquely to the meds - however, I take 1.5 tabs of Sinemet 25/100 5x per day with 3 hour intervals, and 2 tabs of Sinemet 50/200 ER at night before bed. I also take .25 mirapex with my 1st 4 doses of Sinemet. I have no ill effects. It may be that by taking the ER at night, I level out. In your case, that might let you stay with 1 tab in the AM of the regular Sinemet. work with your PD doctor closely to reach your optimum level.

[Hidden in reply to rch21]

thanks!

[jonroberts]

As already mentioned, we all react differently to meds. I have been on Sinemet 25/100 sine 2003 when diagnosed. Prior to DBS in June, I was taking 1.5 tablets every 3 hours 6am-6pm and 200mg Comtan at the same time. I also was taking 50/200 Sinemet CR for overnight I also was taking 3mg Ropenirole 3x 6-12n-6pm. On time was about 45 min, off time over 3 hrs. I experienced dysikensia and rigidity during off time. Since DBS, I take 1 tablet Sinemet at 6am, .5@9-12-3-6 and 1 tablet at 9pm. Still taking 1 tablet Comtan 6-9-12-3-6 and Ropinirole CR 12mg at 6am only. This seems to work, but lately I start feeling run down with fatigue around 4pm. My Impulse Generator settings are 3.5 left side and 2.9 right side. My next appt with Parkinson specialist is Dec 14. After 4 I'm worn out for remainder of the day/evening. Yesterday my wife said I looked "horrible". Any suggestions?

[Hidden in reply to jonroberts]

wow! what does your neuro-guy say about all that?

[wordworks2001 in reply to jonroberts]

Jon, don't be afraid to take an afternoon nap if you already do not take one. I nap as necessary and find my stamina greatly improved.

[mekewero in reply to wordworks2001]

yep that 2 hour grandy(lol) nap helps me ...on afternoon shift ..cleanng

[PatV]

I'm taking 25/100 sinemet and half a sinemet CR pre-breakfast and lunch. Otherwise like you i was wearing off midmorning and could not go to bathroom. Doc had prescribed CR for nighttime but it's more effective in the a.m. or before I have something strenuous to do. Regarding the Mirapex it made me downright bilious throwing up and crazy. Same with Requip and had not much effect on my symptoms.

[Hidden in reply to PatV]

thank you for your input. all food for thought ......

[cabbagecottage]

My husband has been taking Sinemet in different strengths for 5 years . I can't say that they appear to help him that much . He got up to sinemet plus x 4 along with a 250CR at night . I asked the consultant if I could try giving him a lower sinemet along with CR during the day because he was switching off dropping off about 30 mins after taking them . He is now on the Sinemet 100 and takes a CR in the morning as well . I think he is a little better and am now going to try giving him the CR at night and x2 daily . will keep you up to date.

[Hidden in reply to cabbagecottage]

thanks and good luck

[Pete-1]

My variation on this theme is 25/100 Madopar 4 times per day, Pramipexole E/R (Mirapexin extended Release) 2.52 mg and 1x 10mg Selegiline.

Madopar is effectively the same as Sinemet, I thought it (Levodopa) had a 4 hour lifetime in the body before being eliminated via the urine.. Of that 4 hours the first hour is rubbish then the second hour reaches peak efect and the last 2 hour gradual decline. I say gradual but symptoms often seem to return very suddenly especially when negotiating a path through the throngs at the local supermarket.

Often that 4 hours does seem to be rather less and sometimes a dose desn't seem to reach its full potential and I am left with gait freezing problems until much longer than I expect.

I believe that taking a stronger dose does not give you much longer benefit. Rather a more profound benefit is felt for the same period.

So, if one is up for 16 hours then 4 times whatever dose should cover the 16 hours but I feel that a dose every 3.25 hours but 5 times a day would be better for me and perhaps for some others who have contributed to this thread too.

I sometimes take a dose early but because it takes an hour before much change is felt there is very little benefit if you are busy doing something but have to stop and wait for an hour before you have enough Dopamine available. That means you need to anticipate needing an extra pill 1 hour before you need it - not always easy.

I have heard that some take a soluble version of Sinemet first thing before getting up. This soluble version gets to work comparatively quickly so that you don;'t need to wait too long.

Well what a boring post that was - did you read the whole thing? lol

[Hidden in reply to Pete-1]

LOL Yes I did read your entire post. AND I was particularly interested in your thoughts on the stronger dose not lasting longer, but being more powerful. Never thought of it that way, but you may be on to something. I also like the idea of 5 doses daily instead of 4 (I've recently been told by my neuro-guy to go to 4x daily from 3x daily which has helped because my days are often longer than 12 hours). thanks for your input!

[cabbagecottage]

Please keep in touch and let us know how you all get on with the different regimes of medication .

I have my own GUT feelings but worry that I might be making a mistake .

I will try not to be boring lol

I have today taken things into my own hands and am starting giving my husband an extra Sinemet Cr . I want him to feel able to cope all day not a 2 hours after he has taken his Sinemet .

He took a Sinemet CR at 10.30.pm the a Sinemet 100mg at 9am a Sinemet CT at 11.am now he is going to take a CR at 5 pm , will then give him a 100 mg 7pm . Fingers x .... after all the consultants nurses doctors prescribe these medications but don't come home with us and see how they work ..

My husband is 77 and also waiting for a second knee op Hope it works better than the last op because I went out shopping yesterday, away from him for 2 hours and came home to him flat on the floor .. Fortunately that doesn't happen often .

[alllowercase]

Hi

Yes, i am supposed to be on 5 x 25/100 sinemet daily and 1 x 8mg slow release ropinerole daily at 9 am, but currently take 6 sinemet and an extra 2 mg normal release ropinerole at night. Seems to work about 75 / 80 % of the time.

Adrian

[onlymebarb]

i HAVE MSA WHIVH IS ( MULTIPLE SYMPTOM ATROPHY) IT IS A FORM OF PARKINSON'S, WITHALL THE SINEMET I TAKI CANNOT TELL IF IT IS WORKING OR NOT.

[mekewero]

i'm also on sinemet.dosge(along with ropinorol) is meant to be 3 times daily, as other people ,it runs out after 4 hours.so I have settled on that,because I work 35 hours a week,.sinemet is for shakes/trembling aye ?

[fordy40]

I have been struggling with Parkinson's for 21yrs now. I am very discouraged, tired of all of it. I am on Stalevo 200mg x 6 daily or every 4 hrs. Wears off in only 2 hrs, I am left totally paralyzed. I need to take something every 2 hrs. so as not to plummet to rock bottom 8 times a day. Does anyone have any suggestions as to what and how much I need every 2 hrs. I can handle dyskenesias easier than the constant hard tremoring. I am in the late stages now, ready to go, waiting for God to take me home. I am broken and can't help anyone and I am useless. Don't need to be taking up space, how much longer and am I better off just not taking any more doses and just go out whatever happens on what I take now? Thank you, Ledford